title: Tramadol abuse in a binge pattern in a young depressed woman.
abstract: BACKGROUND
  Tramadol is a central analgesic with a unique pharmacological profile in that it is an opioid agonist and an inhibitor of serotonin and norepinephrine reuptake. We describe a case of abuse of tramadol in a binge pattern in a young woman who had initially received the prescription of tramadol as an analgesic as needed.
  
  
  METHODS
  The patient had no history of drug or alcohol abuse, but suffered from depression. Over time, she had increased the doses up to 30 ml of tramadol 100 mg/ml oral solution a week. She took the drug in consecutive 'pinches', from afternoon to evening. Tramadol improved her mood, gave her euphoria, but also caused constipation and urinary retention. Detoxification was carried out by partial replacement with tramadol 100 mg extended release and gradual reduction of the number of pinches. The patient found it hard to follow the program because of withdrawal symptoms of an opioid type and especially because of the worsening of depression.
  
  
  CONCLUSIONS
  The action of tramadol on the monoaminergic system is believed to be a factor that limits abuse liability and gives advantageous antidepressant-like properties, but it also involves the risk of inducing abuse of the analgesic to improve mood as if it were a stimulant.
authors.affiliation: Division of Toxicology and Clinical Pharmacology, University of Modena and Reggio Emilia, Modena, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Ferrari
authors.forename: Ilaria
authors.initials: I
authors.lastname: Tiraferri
authors.forename: Federica
authors.initials: F
authors.lastname: Palazzoli
authors.forename: Manuela
authors.initials: M
authors.lastname: Licata
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects*; D003863:Depression / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006801:Humans; D009293:Opioid-Related Disorders / Q000175:diagnosis* / Q000523:psychology; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis* / Q000523:psychology; D014147:Tramadol / Q000009:adverse effects*
chemical_list: D000701:Analgesics, Opioid; D014147:Tramadol